Medicaid fraud is the intentional providing of false information to get Medicaid to pay for medical care or services. The Arkansas Attorney General’s office fights Medicaid fraud through its Medicaid Fraud Control Unit. The unit investigates and prosecutes violations of State and federal law involving Medicaid providers and the abuse or neglect of clients. Knowingly filing dishonest claims in order to attempt to collect money through the government Medicaid program can result in the loss of licenses and carry with it prison terms and/or large fines.

Two examples of Medicaid fraud are as follows:
• Billing for services not rendered. An example of this would be submitting timesheets that are false. If you did not see your client, you cannot bill for it.
• Double billing. Each client is allotted a certain number of hours by the state for their services. A client cannot receive the same services from two separate companies. Therefore, if you work for multiple agencies, you cannot bill for the same services for the same client for both companies.

The electronic visit verification (EVV) system is one way to prevent fraud, waste, and abuse in the Medicaid program. The 21st Century Cures Act—which was signed into law in 2016—requires state agencies to implement a system of EVV for personal care services and home health care services provided and reimbursed under Medicaid. The EVV mandate is designed to enhance quality and accuracy of care services.

Electronic Visit Verification is a process that uses electronic means to verify that Medicaid fraud is not occurring and protect clients by ensuring they get the care they need.

The information collected during visits includes:
• the date of service provided
• the start time and end time for service provided
• the type of health care service performed
• the location of the service provided
• information about the service provider.

On October 22, 2019, CMS approved the Arkansas EVV Good Faith Effort Exemption request. This means the State has until January 1, 2021, to implement the EVV program. For this initial implementation, EVV will be used for personal care, attendant care, and respite services. Elite Care, LLC has implemented the EVV system as required by the state. We also provide support to caregivers that are experiencing issues with the system or that are new to it. If you have any questions or have any issues, please contact the office to receive assistance.